Provider Demographics
NPI:1932099314
Name:BLOMME, MARTHA ALICIA (CHW)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:ALICIA
Last Name:BLOMME
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:ALICIA
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:109 S 5TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-2537
Mailing Address - Country:US
Mailing Address - Phone:507-537-1950
Mailing Address - Fax:507-337-1951
Practice Address - Street 1:109 S 5TH ST STE 100
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-2537
Practice Address - Country:US
Practice Address - Phone:507-537-1950
Practice Address - Fax:507-337-1951
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker